胃黏膜菌群与幽门螺杆菌的相关性

除幽门螺杆菌之外,胃黏膜内还定居着大量细菌,占主导地位的是厚壁菌门、变形菌门、拟杆菌门、放线菌门和梭杆菌门。幽门螺杆菌和胃黏膜菌群之间可通过竞争营养和空间、扰乱抑菌肽的分泌以及改变宿主胃生理环境等直接或间接相互影响。本研究总结了胃内正常菌群的组成特征,分析了胃黏膜菌群与幽门螺杆菌之间的相互关系及其潜在机制,并进一步探讨了胃黏膜菌群对幽门螺杆菌相关胃部疾病的影响,有利于深入理解慢性胃病的发病机制,为疾病预防及治疗提供理论依据。     

高盐溶液预处理幽门螺杆菌对蒙古沙土鼠胃黏膜损伤作用

目的 探讨高盐预处理的幽门螺杆菌(H.pylori)对胃黏膜的损伤作用。 方法 将30%高盐预处理前后的胃癌来源的H.pylori菌株(4854)灌胃蒙古沙土鼠(MGs),在灌胃后13、26和73周解剖动物,通过组织病理学检查、免疫组化染色和黏膜厚度测量,探讨高盐预处理的H.pylori对胃黏膜的损伤作用。 结果 与未加盐预处理的相应菌株相比,高盐预处理组小鼠的慢性炎症、黏膜变性/坏死、腺体萎缩伴肠上皮化生的发生率较低,黏膜糜烂/溃疡和黏膜上皮增生的发生率较高,差异均有统计学意义(t=8.325 6,P=0.040 8)。第73周,高盐预处理4854菌株组胃体和胃窦黏膜增生显著高于未加盐预处理组(t=12.802 4,P=0.035 1;t=16.536 0,P=0.043 8)。 结论 高盐预处理改变了H.pylori的体内致病性,有助于阐明H.pylori感染与高盐饮食在胃病中的相互作用模式。     

幽门螺杆菌相关性胃炎内镜下胃黏膜表现与中医辨证分型的相关性研究

目的探讨幽门螺杆菌相关性胃炎内镜下胃黏膜表现与中医辨证分型之间的相关性,为临床中医辨证论治提供理论依据。方法收集我院治疗且符合纳入标准的幽门螺杆菌相关性胃炎患者212例,记录患者临床资料并进行中医辨证分型,结合内镜下胃黏膜征象,对数据进行统计分析。结果 212例患者内镜下胃黏膜征象与中医辨证分型之间的相关性具有统计学意义(P0.01);所收集的病例中肝胃气滞证(21.7%)脾胃湿热证(20.1%)脾胃气虚证(18.4%)肝胃郁热证(13.7%)胃阴不足证(11.3%)脾胃虚寒证(7.5%)胃络瘀阻证(6.6%),各中医证型的发病率比较差异具有统计学意义(P0.01)。内镜下各胃黏膜征象之间,红斑渗出型以肝胃气滞证居多,隆起糜烂型以脾胃湿热证居多,胆汁反流型以肝胃气滞证居多,皱襞萎缩型以胃阴不足证居多,出血型以胃络瘀阻证居多,均具有统计学意义(P0.05)。结论幽门螺杆菌相关性胃炎内镜下胃黏膜表现与中医辨证分型之间存在一定的相关性和规律性。     

胃黏膜定植乳酸杆菌对幽门螺杆菌感染的影响

目的 探讨胃黏膜定植乳酸杆菌对幽门螺杆菌感染及胃黏膜菌群数量的影响。方法 收集130例慢性胃炎患者胃窦黏膜组织,病理学检测幽门螺杆菌,提取胃黏膜基因组DNA,采用荧光定量PCR法检测乳酸杆菌和总细菌数。结果 幽门螺杆菌阳性组和阴性组的乳酸杆菌检出率和乳酸杆菌数（Log）差异均无统计学意义（P>0.05）;乳酸杆菌阳性者和阴性者之间胃黏膜总细菌数（Log）差异无统计学意义（P>0.05）;乳酸杆菌细菌数（Log）与胃黏膜总细菌数（Log）无显著相关性（P>0.05）;不同炎症程度胃炎患者乳酸杆菌检出率差异无统计学意义（P>0.05）;肠化组和未肠化组乳酸杆菌检出率差异无统计学意义（P>0.05）;但是重度胃炎组幽门螺杆菌感染率和总细菌数量均显著高于轻度（P<0.05）和中度胃炎组（P<0.05）。结论 胃黏膜定植乳酸杆菌对幽门螺杆菌的感染无影响,其存在与否及细菌数量对胃黏膜总细菌数亦无明显影响,并与胃炎炎症程度及肠化无关。乳酸杆菌不能通过抑制幽门螺杆菌定植、调节胃黏膜菌群而减轻炎症反应。     

中西医结合治疗对幽门螺杆菌感染性胃溃疡患者胃黏膜的影响

目的 探讨中西医结合治疗对H. pylori感染性胃溃疡（Hp-GU）患者胃黏膜形态的影响及疗效。方法 选择2016年1月至2018年4月在我院内科治疗的Hp-GU患者74例,随机分为观察组与对照组各37例。两组患者均予以泮托拉唑肠溶片（40 mg/次,2次/d）、阿莫西林胶囊（1.0 g/次,2次/d）、左氧氟沙星片（0.2 g/次,2次/d）和枸橼酸铋钾胶囊（240 mg/次,2次/d）进行治疗,连用2周,2周后继续使用泮托拉唑肠溶片40 mg/次,1次/d,再用4周。观察组患者在此基础上加用半夏泻心汤加减治疗,连用6周。观察两组患者治疗前后胃黏膜形态的变化,并比较溃疡愈合情况、H. pylori清除率及患者不良反应。结果 治疗6周后,两组患者胃黏膜厚度、腺体密度及慢性炎症细胞浸润和活动性炎症细胞浸润评分较治疗前明显下降（P0.05）,观察组患者H. pylori清除率显著高于对照组（χ2=4.39,P<0.05）。结论 中西医结合治疗对Hp-GU患者的疗效确切,能显著改善患者胃黏膜形态,提高H. pylori清除率,且患者不良反应少,安全性较高。     

幽门螺杆菌毒力基因分型与相关胃病

幽门螺杆菌毒力基因是其致病的原因之一,目前已知的主要毒力基因包cagPAI,vacA,iceA,babA等,不同毒力基因分型及其结合与相关性胃疾病的关系在不同地区报道不同。对幽门螺杆菌毒力基因分型的研究有利于鉴别其毒力菌株,揭示其致病机制及为幽门螺杆菌感染的流行病学研究提供帮助。     

幽门螺杆菌感染胃组织基因芯片生物信息学分析

为探讨幽门螺杆菌感染胃组织后差异基因变化,深入分析参与疾病发生、发展的分子机制。从GEO(Gene Expression Omnibus)数据库下载幽门螺杆菌感染胃组织基因芯片数据(GSE5081),根据胃粘膜组织是否受损分组,分别比较幽门螺杆菌感染者与阴性对照组,获得差异基因并进行功能分析包括GO分析、信号通路分析,基因相互作用及基因共表达,得到重要核心基因,并通过实时定量PCR方法进行验证。结果表明:得到参与幽门螺杆菌感染后上调的44个主要基因,主要涉及的GO分析及信号通路包括免疫反应、炎症反应、抗原提呈、细胞因子通路、因子受体关联,细胞粘附分子等。研究发现核心基因CXCR4,CCL20,JAK3,TNFAIP2,PLEK,HLA-DMA,PTPRC,CXCL13,BCL2A1,并通过实时定量PCR的方法进行部分验证,CXCR4,CXCL5,CXCL2在幽门螺杆菌感染后的胃黏膜组织表达高于对照组。幽门螺杆菌感染后胃粘膜组织引起免疫反应,炎症反应,抗原提呈,因子受体关联,细胞粘附分子通路的激活。同时发现一些主要的趋化因子相关基因CXCR4,CXCL5,CXCL2,CCL20,CXCL1等,涉及增殖,炎症,免疫,凋亡基因JAK3,TNFAIP2,PLEK,HLA-DMA,PTPRC,BCL2A1等的表达上调,并实时定量PCR验证部分相关基因的表达。这些结果为从分子网络机制层面上认识幽门螺杆菌感染提供分析思路及基础。     

幽门螺杆菌毒力相关基因及所致疾病

幽门螺杆菌（Ｈｐ）作为各种常见胃肠疾患的重要病原已得以确认,但其确切的致病机制的尚未阐明。目前倍受关注的是其两个特征性致病因子：细胞空泡毒素（ＶａｃＡ）和细胞毒相蛋白（ＣａｇＡ）。国外科研人员对这两种因子编码基因、同常见胃肠疾患的相关性以及在ＨＰ致病机制中的作用进行了广泛而深入的研究。     

宿主基因单核苷酸多态性与幽门螺杆菌相关胃癌

幽门螺杆菌相关胃癌是一种由遗传、环境、生活方式等因素共同作用所致的特殊类型胃癌。它的发病过程至少包括炎症、萎缩和癌变3个主要阶段。宿主基因单核苷酸多态性(SNP)包括炎症反应、胃酸抑制、免疫识别等相关基因SNP,可能特异性参与了幽门螺杆菌相关胃癌发生发展过程中的不同阶段。文章综述与幽门螺杆菌相关胃癌发病3个主要病理阶段相关的宿主基因SNP及其与胃癌发病风险关系的研究进展。     

胃幽门螺杆菌感染与口臭的相关性研究

目的:探讨胃幽门螺杆菌感染与口臭发生的相关性。方法:选取48例口臭患者为研究对象,另选取96例无口臭的健康志愿者为无口臭组,通过13C呼气试验检测所有研究对象幽门螺杆菌的感染情况,比较两组幽门螺杆菌的感染率。根据是否感染幽门螺杆菌分为感染组和无感染组,比较两组口臭的发生率,分析幽门螺杆菌感染与口臭发生的相关性。结果:口臭组和非口臭组患者幽门螺杆菌的感染率分别为79.17%,27.08%,口臭组显著高于无口臭组,差异有统计学意义(x2=35.16,P0.05)。口臭与幽门螺杆菌的感染显著相关(r=0.4)。幽门螺杆菌感染组患者和未感染组口臭的发生率分别为70.31%和3.75%,感染组显著高于未感染组,差异有统计学意义(x2=70.89,P0.05)。幽门螺杆菌的感染与口臭的发生率显著相关(r=0.69)。结论:幽门螺杆菌感染与口臭的发生有密切的相关性,是引起口臭的一个重要因素。     

A prospective analysis of low-grade gastric malt lymphoma after Helicobacter pylori eradication

BACKGROUND: Primary gastric low-grade B-cell lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma) is known to be successfully treated with anti-Helicobacter pylori (H. pylori) therapy alone. However, there are few reports on long-term results after eradication therapy. The aims of this study were to analyze the rate and the interval to reach complete remission (CR), and to assess the rate and the factors affecting recurrence of MALT lymphoma. MATERIALS AND METHODS: Between 1996 and 2003, a total of 90 H. pylori-infected patients with low-grade MALT lymphoma were included in this study. For initial staging, endoscopic ultrasonography, chest-abdomen-pelvis CT scans, and bone marrow examination were taken. All patients were made to take anti-H. pylori therapy for 14 days. Tumoral response was assessed by endoscopy every 3 months till CR and every 6 months after achieving CR. RESULTS: Among 90 treated patients, 85 (94.4%) reached CR. The median interval to CR was 3 months (range, 1-24). Seventy-nine (92.9%) patients were in CR at 12 months. Median follow-up period after CR was 45 months (range 15-109). Among 77 patients who were followed-up after CR, 8 (10.4%) patients were proved with recurrence of MALT lymphoma. Cumulative recurrence rate was 2.7, 11.5, and 12.2% at 1, 2, and 3 years. The presence of H. pylori was only a significant risk factor affecting recurrence. CONCLUSIONS: The status of H. pylori is the most important risk factor affecting recurrence. Therefore, adequate eradication regimen and accurate regular evaluation for H. pylori status are needed during follow up of primary gastric low-grade B-cell MALT lymphoma.     

胃息肉与幽门螺杆菌感染关系研究

目的探讨胃息肉与幽门螺杆菌（Helicobacter pylori,H.pylori）感染关系。方法对1218例胃息肉同时进行H．pylori检查患者进行回顾性分析,分析胃息肉患者H.pylori感染率、胃息肉部位与H.pylori感染关系、胃息肉病理类型与H.pylori感染关系。结果发现胃息肉Hpylori感染患者532例,Hpylori感染率为43．7％。男性胃息肉患者H.pylori感染率为47．5％（216／455）,女性Hpriori感染率感染率为41．4％（316／763）（P〉0．05）,年龄〈20岁、20～39岁、40—59岁和≥60岁胃息肉H.priori感染率分别为41．7％、44．7％、41．6％和47．2％（P〉0．05）;胃窦胃角息肉H.pylori感染率高于其他部位（胃体、胃底和贲门）（P〈0．05）;炎性和增生性胃息肉H.priori感染率高于胃底腺和腺瘤性息肉（P〈0．05）。结论H.pylori感染可能与部分胃息肉发生有一定关系,需要进一步深入研究胃息肉的发生机制。     

Comparison of localized gastric mucosa-associated lymphoid tissue (MALT) lymphoma with and without Helicobacter pylori infection

BACKGROUND: The clinical features and clinical course of Helicobacter pylori-negative gastric mucosa-associated lymphoid tissue (MALT) lymphoma are unclear and a treatment strategy has not yet been established. AIM: To clarify the clinical differences between H. pylori-positive and H. pylori-negative gastric MALT lymphoma, we compared these two types of gastric MALT lymphoma. MATERIALS AND METHODS: Fifty-seven patients with localized gastric MALT lymphoma were studied. H. pylori infection was present in 41 and absent in 16. Treatment consisted of antibiotic therapy and/or 30 Gy radiation therapy. Response assessment was performed every 3-6 months by esophagogastroduodenoscopy including gathering biopsy samples, endoscopic ultrasonography, clinical examination, and various imaging procedures. The median follow-up period was 37 months. RESULTS: There were no significant differences between H. pylori-positive and H. pylori-negative gastric MALT lymphoma patients in terms of sex, age, stage, gross phenotype, affected area of the stomach, or the presence of monoclonality. Complete regression was achieved with antibiotic therapy against H. pylori-negative gastric MALT lymphoma in one of nine patients (11.1%), compared to 28 of 38 patients (73.7%) with H. pylori-positive gastric MALT lymphoma (p < .001). Radiation therapy showed high effectiveness for the local control of H. pylori-negative or antibiotic-resistant gastric MALT lymphoma (92.9%), although distant recurrence was recognized in three of 14 patients (21.4%). Two of 16 patients (12.5%) with H. pylori-negative gastric MALT lymphoma died because of the transformation of the disease into diffuse large B-cell lymphoma. There was a significant difference in both the overall and cause-specific survival rate between the two groups (p = .038). CONCLUSION: Radiation therapy is the effective treatment for H. pylori-negative or antibiotic-resistant localized gastric MALT lymphoma. However, careful systemic follow-up for distant involvement should be required. Transformation into diffuse large B-cell lymphoma is thought to be the important cause of death in patients with gastric MALT lymphoma.     

Helicobacter pylori infection up-regulates gland mucous cell-type mucins in gastric pyloric mucosa

Background. Two types of mucous cell are present in gastric mucosa: surface mucous cells (SMCs) and gland mucous cells (GMCs), which consist of cardiac gland cells, mucous neck cells, and pyloric gland cells. We have previously reported that the patterns of glycosylation of SMC mucins are reversibly altered by Helicobacter pylori infection. In this study, we evaluated the effects of H. pylori infection on the expression of GMC mucins in pyloric gland cells. Methods. Gastric biopsy specimens from the antrums of 30 H. pylori‐infected patients before and after eradication of H. pylori and 10 normal uninfected volunteers were examined by immunostaining for MUC6 (a core protein of GMC mucins), α1,4‐N‐acetyl‐glucosaminyl transferase (α4GnT) (the glycosyltransferase which forms GlcNAcα1‐4Galβ‐R), and GlcNAcα1‐4Galβ‐R (a GMC mucin‐specific glycan). Results. MUC6, α4GnT, and HIK1083‐reactive glycan were expressed in the cytoplasm, supranuclear region, and secretory granules in pyloric gland cells, respectively. The immunoreactivity of MUC6 and α4GnT, but not of GlcNAcα1‐4Galβ‐R, in the pyloric gland increased in H. pylori‐associated gastritis, and after the eradication of H. pylori, the increased expression of MUC6 and α4GnT in the gastric mucosa of H. pylori‐infected patients decreased to almost normal levels. This up‐regulation was correlated with the degree of inflammation. Conclusions. In addition to the synthesis of GMC mucins increasing reversibly, their metabolism or release may also increase reversibly in H. pylori‐associated gastritis. The up‐regulation of the expression of gastric GMC mucins may be involved in defense against H. pylori infection in the gastric surface mucous gel layer and on the gastric mucosa.     

pH-dependent binding of Helicobacter pylori to pig gastric mucins

A microtiter-based assay was developed to study the binding of Helicobacter pylori to pig gastric mucins purified by density-gradient centrifugation in CsCl/4 M guanidinium chloride. Binding of H. pylori was observed over the 'mucin' band as well as with 'low-density' components in the gradients, and binding to the latter was more pronounced when incubations were performed at 37 degrees C as compared to 20 degrees C. At a lower pH, binding of H. pylori (strain SVA 40) to the 'high-density' mucins from pig antrum was increased but binding to the 'low-density' ones was decreased. Binding of the P466 strain (Le(b)-specific) was mainly associated with the 'mucin' band, whereas the MO19 strain reacted preferentially with the 'low-density' components. In summary, H. pylori may bind to gastric mucins and the binding is influenced by temperature, pH and the repertoire of bacterial adhesins.     

TFF2在胃癌中的表达及与幽门螺杆菌感染关系的研究

目的探讨三叶因子Ⅱ(Trefoil factors2,TFF2)在胃癌和癌前病变中的表达及与幽门螺杆菌感染(Helicobacter pylori,H.pylori)的关系。方法选取经病理证实的慢性浅表性胃炎、胃溃疡、慢性萎缩性胃炎和胃癌4种不同胃黏膜病变的标本140例,用免疫组化法检测标本中TFF2的表达及H.pylori的感染情况,并分析TFF2的表达与H.pylori的感染的关系。结果在慢性浅表性胃炎、胃溃疡、慢性萎缩性胃炎和胃癌中,TFF2和H.pylori的表达率依序呈逐渐增加的趋势,但TFF2在胃癌组织中表达降低。H.pylori阳性组TFF2的表达率低于阴性组,TFF2的阳性率与H.pylori感染率之间呈负相关(r=-0.335,P<0.05)。结论 TFF2的表达和H.pylori的感染与肿瘤的发生密切相关,检测该指标可为胃癌诊断、判断预后和指导治疗提供理论依据。     

幽门螺杆菌相关miRNA与胃癌关系的研究进展

微小核糖核酸(microRNA,miRNA)是一种由内源基因编码长度约为22个核苷酸的非编码RNA,其能抑制靶基因蛋白质表达,有多种生物学功能。越来越多的研究表明,miRNA在多种肿瘤中异常表达,参与肿瘤发生、发展过程。幽门螺杆菌(Helicobacter pylori,Hp)作为胃癌的主要致病因素,可通过调节miRNA的表达,在胃癌中起促进或抑制作用。现就Hp相关miRNA在胃癌中的作用作一概述。     

Helicobacter pylori antibodies and gastric cancer: a gender-related difference

Helicobacter pylori has been proposed as a causative agent of gastric cancer. The aim of this study was to define serum antibodies response against different H. pylori antigens in patients with gastric cancer. Serum samples were collected from 115 Lithuanian patients with non-cardia gastric cancer and 110 age- and sex-matched controls without cancer. Heat-stable, low-molecular-mass, and outer membrane proteins were used as antigens to analyze serum IgG antibody response against H. pylori by enzyme-linked immunosorbent assay. Seroprevalence of H. pylori using low-molecular-mass antigen was significantly higher in gastric cancer patients, compared to controls (77% versus 57%, p<0.05). Significant differences in the prevalence of H. pylori infection between gastric cancer patients and controls were found in females using all three studied antigens: heat-stable (98% versus 84%, p<0.05), low-molecular-mass (88% versus 48%, p<0.05) and outer membrane proteins (78% versus 57%, p<0.05). In males, no significant differences were revealed between gastric cancer patients and controls. There may be other cofactors in addition to H. pylori that are important for the development of gastric cancer. H. pylori seems, however, to be a more important for development of gastric cancer in females than in males or males may have more confounding risk factors for gastric cancer than females.     

PCR detection of Helicobacter pylori in string-absorbed gastric juice

Molecular methods for detection of Helicobacter pylori infection have been shown to be highly sensitive in gastric biopsies and cultures. The objective of this work was to compare PCR detection of H. pylori DNA in string-absorbed gastric juice and in gastric biopsies. The study was performed in 47 dyspeptic adult patients undergoing endoscopy, and infection was detected by amplification of a segment of H. pylori ureA gene. Of the 29 patients positive in biopsy analysis, 23 (79%) were also positive in the gastric string. PCR analysis of gastric strings is a sensitive and safe procedure to detect H. pylori when endoscopy is not indicated, and may be of great clinical and epidemiological usefulness in determining effectiveness of eradication therapies, typing virulence genes and detecting antibiotic resistance mutations.